Caring for Your Premature Baby

The birth of a baby is a happy time. However, if your baby is born premature, it can be stressful. It can require extra care, too. A baby is premature if he or she is born before the 37th week of a normal 40-week pregnancy.

Path to improved health

Babies who are born prematurely may need special care during their first 2 years. This is especially true if they weighed less than 3 pounds. Here’s some advice on how to care for your baby when he or she comes home from the hospital. Here’s what you can do to help your baby be healthy, grow, and develop when you bring him or her home:

Take your baby to your doctor’s office soon after the baby leaves the hospital. Your doctor will check your baby to confirm that he or she is gaining weight and discuss how your baby is doing at home.

Talk with your doctor about feeding your baby. Breast milk is the best baby food. If your baby does not suck or latch on well, these are problems that can be overcome with help. Ask your doctor to involve a lactation consultant. Breast milk can be fed from a bottle instead of, or in addition to, from the breast. Breast milk can be pumped and stored if you prefer to feed breast milk from a bottle. This is helpful if you are away from your baby due to their care needs or your work. If your baby takes formula instead of breast milk, a special formula may be needed. Your doctor may recommend vitamins and iron. Vitamins are often given to premature babies to help them grow and stay healthy. Your baby also may need extra iron because premature babies do not have as much iron stored in their bodies as full-term babies. After about 4 months of taking iron drops, your baby will have about the same amount of iron as a full-term baby. Your doctor may want your baby to take iron drops for a year or longer.

Watch your baby’s growth. Premature babies may not grow at the same rate as a full-term baby for the first 2 years. Premature babies are usually smaller during this time. Sometimes they grow in spurts. They usually catch up with full-term babies in time. To keep a record of your baby’s growth, your doctor can use special growth charts for premature babies. Your doctor also will want to keep track of your baby’s milestones. This would include things like activity level, sitting up, and crawling. These are things doctors want to know about all babies, not just premature babies.

Be consistent with your baby’s feeding schedule. Most premature babies need 8 to 10 feedings a day. Don’t wait longer than 4 hours between feedings or your baby may get dehydrated (not getting enough fluids). Six to 8 wet diapers a day show that your baby is getting enough breast milk or formula. Premature babies often spit up after a feeding. This is normal. However, you want to make sure that your baby is still gaining weight. Talk to your doctor if you think your baby has stopped gaining or is losing weight.

Prepare for solid food. Most doctors advise giving a premature baby solid food at 4 to 6 months after the baby’s original due date (not the birth date). Premature babies are not as developed at birth as full-term babies. It may take them longer to develop their swallowing ability. If your baby has medical problems, your doctor may recommend a special diet.

Give your baby plenty of opportunity for sleep. Although premature babies sleep more hours each day than full-term babies, they sleep for shorter periods of time. All babies should be put to bed on their backs, not on their stomachs. This includes premature babies. Use a firm mattress and no pillow. Sleeping on the stomach and sleeping on a soft mattress may increase your baby’s risk of sudden infant death syndrome (SIDS). SIDS is the sudden and unexplained death of a baby younger than 1 year (usually while the infant is asleep, which is why it is also called “crib death”).

Check your baby’s vision. Crossed eyes are more common in premature babies than in full-term babies. The medical term for this condition is strabismus. This problem usually goes away on its own as your baby grows and develops. Your doctor may want you to take your baby to an eye doctor if your baby has this problem. Some premature babies have an eye disease called retinopathy of prematurity (ROP). This is where the small blood vessels in the eye grow abnormally. ROP usually occurs in babies who are born at 32 weeks of pregnancy or earlier. If there’s a chance your baby has ROP, your doctor will advise you to take the baby for regular checkups by an eye doctor. ROP can be treated to help prevent vision loss.

Check your baby’s hearing. Premature babies are also more likely than full-term babies to have hearing problems. If you notice that your baby doesn’t seem to hear you, tell your doctor. You can check your baby’s hearing by making noises behind or to the side of the baby. If your baby doesn’t turn his or her head, or react to a loud noise, tell your doctor.

Get your baby’s immunizations. Immunizations (also called vaccines or shots) are given to premature babies at the same ages they are given to full-term babies. Your baby may need a flu shot when he or she is 6 months old. Premature babies might get sicker with the flu than full-term babies. Talk with your doctor about flu shots for your entire family. This can help protect your baby from catching the flu from someone in the family.

Protect your baby while traveling in a car. When traveling with your baby in a car, use a safety-approved infant car seat. Be sure that your baby’s head and body don’t slump over when he or she is in the car seat. You can use rolled-up towels or receiving blankets to give your baby support in the car seat. The car seat should be installed in the back seat. You can have a friend or family member ride in the back seat with your baby to watch him or her. Your baby should start off in a rear-facing car seat. Ask your doctor when it’s safe to move your baby to a forward-facing car seat. Never leave your baby alone in the car, not even for a few minutes.

Things to consider

If your baby is born premature, there are certain things that can affect his or her health, learning, and your family’s schedule. Physically, babies born prematurely may need to stay in the hospital for weeks or months longer than full-term babies. This can be due to the fact that premature babies often struggle with underdeveloped lungs, being underweight, and other problems. This can be a strain on your family’s routine, even if it’s your first child. It requires daily visits to the hospital until he or she is released. If you have other children, it requires dividing your time between the hospital and caring for your children at home. One or both parents may need to take additional time away from work during this period.

Once your baby comes home, you will need to protect him or her from exposure to others and illness. Germs and illness can be tougher on a premature baby. Finally, some premature babies struggle with learning, gross motor (crawling, walking), and fine motor (picking up things, feeding themselves) development. They will eventually catch up. However, it may take them longer to learn those skills.

Questions to ask your doctor

If my first baby was born premature, does that increase the risk for prematurity for additional babies?

How can I help my premature baby catch up on his or her developmental milestones?

How long should I wait to take my premature baby out or expose him or her to others once we’re home?

Can being born premature increase my baby’s risk of cerebral palsy or other chronic health conditions?